Vital Signs

Chronic care management (CCM) is a Medicare service for patients with two or more chronic conditions that pays for care coordination outside face-to-face visits, supported by an electronic comprehensive care plan, 24/7 access, and managed transitions. This post explains the CMS requirements, how complex CCM and newer bundles such as advanced primary care management differ, and what studies found about pharmacist-led CCM revenue, a 26,500-patient platform, and team-based remote monitoring.

APACHE, the Acute Physiology and Chronic Health Evaluation, is a family of severity-of-illness scores that combine early ICU physiology, age, and chronic health status to estimate the risk of hospital death. This post explains how APACHE II and IV work, what a 145-patient trauma study and a 159-admission COPD study found about their accuracy, what a systematic review found in low- and middle-income countries, and why calibration matters as much as discrimination.

A zero-day threat exploits a security vulnerability that the software developer does not yet know about, so no fix exists at the time of the attack. This post explains why zero-days are hard to defend against, what a systematic review found about why health care systems are vulnerable, what a 2026 study of meta-learning intrusion detection reported using benchmark datasets, and what practical layers reduce exposure when no patch is available.

In education, a simulation resembles a real-life situation a learner might meet so that decisions can be practiced safely. In health informatics, simulation is also used to test new systems before go-live. This post explains both uses, what a pediatric hospital found when in situ simulations and usability testing produced 475 recommendations before an EHR transition, what a review of 52 nursing simulation studies found about self-efficacy, and what studies of EHR training reported.

QRDA is the HL7 standard that gives quality measure results a structured, consistent format so they can be sent between systems and reported to programs such as those run by CMS. This post explains the difference between patient-level Category I files and aggregate Category III files, how federal certification rules and CMS implementation guides use them, and what research shows about eCQM design, testing, and the burden of reporting.

Nutrition informatics is the effective retrieval, organization, storage, and use of information, data, and knowledge to solve food and nutrition problems and support decisions. This post explains the Nutrition Care Process and its standardized terminology, what a Swiss audit of 92 records found about documentation quality, what a mixed methods study of 4,426 dietitians found about barriers and enablers, and how an automated malnutrition screening model performed using two data points.

A HISP, or health information service provider, is the Direct Project’s term for both a function, managing security and transport for directed exchange, and an organization that performs that function for senders and receivers. This post explains what a HISP does behind a Direct address, why a HISP can be a HIPAA business associate, what the regulation says about Direct in certified EHRs, and how directory management and growth statistics from the literature show the importance of this layer.

Direct messaging is a secure, encrypted, email-like way to send sensitive clinical and administrative information from one identified sender to one identified recipient. This post explains how it fits into ONC certification, what a radiology study found when Direct addresses grew from 8,724 to 752,496 in two years, why address directories decide whether a message can be sent, and what happens when recipients receive more outside data than they can manage.

The CMS Promoting Interoperability programs are the successors to the Medicare and Medicaid EHR Incentive Programs, using certified EHR technology and measure reporting to promote the exchange of health data. This post explains how the Medicare program for hospitals and the MIPS category for clinicians differ, what hospitals must submit to public health agencies, and what a 2012 to 2024 analysis found about patient portal adoption alongside federal policy.

An archetype is a named, machine-readable model that specifies how a clinical concept, such as a blood pressure observation or a medication order, should be captured and stored. This post explains how openEHR separates clinical models from software, how archetypes combine into templates, and what case studies of a coronary CT registry, a pediatric sepsis alert, a blood pressure monitoring module, and a corneal transplant record found.

Workflow management is an approach that defines and controls business processes spanning multiple applications, and it covers automating the tasks within them. This post explains how it differs from workflow design, what a process mining study of 43,183 events in radiotherapy found about suspension delays, what a scoping review of 16 studies found about referral documentation tools, how robotic process automation cut cancer registry abstraction time, and what a scoping review of 28 studies says about usability and workflow.

In information security, a threat is any circumstance or event with the potential to harm an organization, its assets, or individuals through an information system, and also the potential for a threat source to exploit a vulnerability. This post separates threat from vulnerability and risk, then reviews what interviews with emergency and IT staff, a literature review of emergency medicine, and a hospital phishing simulation in Norway say about how threats reach patient care.

Risk management is the ongoing work of directing and controlling an organization with regard to risk, and in health care it spans clinical safety as well as information security. This post explains the four meanings in the HIMSS Dictionary, the HIPAA risk management requirement, the NIST Risk Management Framework, what a study of eight organizations found about adherence to EHR safety practices, and what a review of 300 failure modes in adaptive radiotherapy shows about where risk concentrates.

NEDSS is an initiative that promotes data and information system standards to build efficient, integrated, and interoperable disease surveillance systems at federal, state, and local levels. This post explains how NEDSS fits with public health reporting, what a 2011 assessment found about state system capacity, what an Illinois pilot found when electronic case reports were compared with laboratory reports, and what the US Virgin Islands learned from migrating its NEDSS Base System to the cloud.

An IHE profile is a documented, tested specification from the Integrating the Healthcare Enterprise initiative that shows how existing standards should be combined to meet a specific integration need. This post explains how profiles are developed and tested, how Taiwan used the cross-enterprise document sharing profile for its national electronic medical record exchange across 321 hospitals, and what pilots of the XDS-I imaging profile found.

ePHI is protected health information that is created, stored, transmitted, or received electronically, and it is the information the HIPAA Security Rule exists to protect. This post explains the regulatory definition, the Security Rule’s general requirements and technical safeguards, what a 6,612-breach analysis shows about hacking and business associates, and what phishing simulation studies in US health care found about employee click rates and training.

A clinical data warehouse (CDW) groups data from diverse sources about a health system so it can be analyzed for secondary purposes such as quality measurement and research. This post explains how a CDW differs from the EHR, what a Paris pilot found when it automated a stroke quality indicator for more than 6,000 records, what a national rare eye disease warehouse needed to meet strict data protection rules, and why coding alone can misclassify patients.

The American Recovery and Reinvestment Act of 2009 (ARRA) was an economic stimulus law that included the Health Information Technology for Economic and Clinical Health (HITECH) Act, which funded incentives for hospitals and physicians to adopt certified EHRs. This post explains what HITECH did, what a difference-in-differences study found about its effect on hospital EHR adoption, how Germany’s different approach compared, and the lessons of the first five years.

Wi-Fi is wireless networking technology that uses radio waves to provide high-speed network and internet connections, and the term is used for wireless local area network products based on the IEEE 802.11 standards. This post explains how the standard and the trademark relate, what NIST and the HIPAA transmission security standard say about securing wireless networks, and what research shows about wireless coexistence of medical devices and the security exposure of connected equipment.

A third-party administrator (TPA) is an organization that administers group health plans for an employer, processing claims, determining eligibility, and passing information between the employer and the insurer. This post explains how TPAs fit into self-insured employer coverage, why they are HIPAA business associates, how the standard claims and remittance transactions work, and what research on the administrative services only market and price transparency found.